Shaping Up Teeth – Part 2 – Build ups changing bites (Increasing the vertical dimension)
In a mouth with very worn teeth, we can build up the bite with bonded tooth coloured materials. This is called increasing the vertical dimension. The vertical dimension is the distance between the jaw bones when the teeth are fully biting. The closer the jaw bones are together the shorter the teeth are and the stronger the bite will be.
The teeth can become very short quickly, once the enamel has been worn, exposing the less wear resistant dentine. If the wear continues then the exposed dentine is prone to increased sensitivity, decay and exposing the nerve! The remaining enamel needs the dentine to support its structure. Without it, the enamel the chips and even cracks! Furthermore cracks can involve the dentine and eventually the root. This can spell the end of the tooth, especially if it’s a vertical fracture. Ouch!
By building up the teeth to increase the vertical dimension, this prevents the jaws from over closing and reducing the pressure on the teeth and fillings. The fillings will also be thicker and stronger and look better.
The exposed dentine will be covered to prevent sensitivity, wearing and protect the nerve. There will be a reduction in the incidence of cracking of teeth. There is also reduced pressure on the gums and the surrounding bone. This can reduce the severity of gum disease and mobility of teeth.
The build-up treatment has to be done in one visit, by building up a section at a time. (Yes, thankfully, you can have a rest during the procedure!)The aim is provide an even bite on all the teeth and this includes building up denture teeth as well if they are present.
A visit in a week is required to ensure the bite remains even as the body gets used to the changes. Adjustments to the fillings may need to be done. Anaesthetics are not usually need as we are adding to the tooth.
If there is a history of heavy grinding of teeth, causing damage, then an appliance can be made to protect all the teeth. It is usually worn at night and called an occlusal splint. This provides an even bite on a firm cushioned material. This can be made over the build-up if necessary.
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